{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T04:40:28Z","timestamp":1759725628892,"version":"build-2065373602"},"reference-count":21,"publisher":"BMJ","issue":"12","funder":[{"name":"National famous and old Chinese medicine experts (Xuemei Zhang, Xiaohua Yan) inheritance studio construction project"},{"name":"Fujian Province Natural Science Fund Project","award":["2021J02053, 2020J011064, 2021J01704, 2022J01996"],"award-info":[{"award-number":["2021J02053, 2020J011064, 2021J01704, 2022J01996"]}]},{"name":"the Fujian Province Medical Innovation Foundation","award":["2021CXB001"],"award-info":[{"award-number":["2021CXB001"]}]},{"name":"Special Research Foundation of Fujian Provincial Department of Finance","award":["No. 2020-822, 2021-848, 2021-917, 2022-840"],"award-info":[{"award-number":["No. 2020-822, 2021-848, 2021-917, 2022-840"]}]},{"name":"Startup Fund for scientific research of Fujian Medical University","award":["2021QH1272"],"award-info":[{"award-number":["2021QH1272"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Med Genet"],"accepted":{"date-parts":[[2023,7,11]]},"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:p>To date, over 200 families with hereditary leiomyomatosis and renal cell carcinoma (HLRCC) and over 600 families with Birt\u2013Hogg\u2013Dub\u00e9 (BHD) syndrome have been reported, with low incidence. Here, we describe a patient with suspected rare HLRCC complicated by BHD syndrome. The proband (II1) had characteristic cutaneous leiomyoma-like protrusions on the neck and back, a left renal mass and multiple right renal, liver and bilateral lung cysts. Three family members (I1, II2, II3) had a history of renal cancer and several of the aforementioned clinical features. Two family members (II1, II3) diagnosed with fumarate hydratase (FH)-deficient papillary RCC via pathological biopsy carried two heterozygous variants: <jats:italic>FH<\/jats:italic> (NM_000143.3) missense mutation c.1189G&gt;A (p.Gly397Arg) and <jats:italic>FLCN<\/jats:italic> (NM_144997.5) frameshift mutation c.1579_1580insA (p.Arg527Glnfs*75). No family member carrying a single variant had renal tumours. In HEK293T cells transfected with mutant vectors, mRNA and protein expression after <jats:italic>FLCN<\/jats:italic> p.Arg527Glnfs*75 and <jats:italic>FH<\/jats:italic> p.Gly397Arg mutations were significantly lower than those in wild-type (WT) cells. Cell immunofluorescence showed altered protein localisation and reduced protein expression after <jats:italic>FLCN<\/jats:italic> p.Arg527Glnfs*75 mutation. The FH WT was uniformly distributed in the cytoplasm, whereas FH protein expression was reduced after the p.Gly397Arg mutation and scattered sporadically with altered cell localisation. Patients with two variants may have a significantly increased penetrance of RCC.<\/jats:p>","DOI":"10.1136\/jmg-2023-109328","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T13:33:52Z","timestamp":1689773632000},"page":"1210-1214","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical phenotype and genetic function analysis of a rare family with hereditary leiomyomatosis and renal cell carcinoma complicated with Birt\u2013Hogg\u2013Dub\u00e9 syndrome"],"prefix":"10.1136","volume":"60","author":[{"given":"Hong-Hong","family":"Pan","sequence":"first","affiliation":[{"name":"Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China"},{"name":"Department of Urology, Fujian Provincial Hospital, Fuzhou, Fujian, 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China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin-Fu","family":"Lin","sequence":"additional","affiliation":[{"name":"Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China"},{"name":"Pediatrics Department, Fujian Provincial Hospital, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China"},{"name":"Pathology Department, Fujian Provincial Hospital, Fuzhou, Fujian, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao-Bin","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Traditional Chinese Medicine, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, 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